Some side effects of indinavir may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Hepatic

Asymptomatic hyperbilirubinemia (total bilirubin at least 2.5 mg/dL [43 mcmol/L]) has been reported in about 14% of patients, primarily as elevated indirect bilirubin; this was associated with elevated ALT, AST, or alkaline phosphatase in less than 1% of patients. Most patients continued therapy without dose reduction and bilirubin values gradually declined towards baseline. Hyperbilirubinemia was reported more often at doses greater than 2.4 g/day compared to doses up to 2.4 g/day.

Increased total serum bilirubin (greater than 250% ULN), ALT (greater than 500% ULN), and AST (greater than 500% ULN) have been reported in up to 11.9%, up to 4.9%, and up to 3.7% of patients, respectively.[Ref]

The cumulative frequency of nephrolithiasis events increased with duration of drug exposure; however, risk over time remained relatively constant. Of patients who developed nephrolithiasis/urolithiasis in clinical trials, 7 of 246 developed hydronephrosis and 11 of 246 underwent stent placement; after the acute episode, 12 of 246 patients discontinued therapy. In general, nephrolithiasis (including flank pain with or without hematuria [including microscopic hematuria]) was not associated with renal dysfunction and resolved with hydration and temporary interruption of therapy (e.g., 1 to 3 days). Nephrolithiasis/urolithiasis was reported more often at doses greater than 2.4 g/day compared to doses up to 2.4 g/day.

Increased creatinine (greater than 300% ULN) has been reported in up to 0.2% of patients.

During postmarketing experience, interstitial nephritis did not resolve after some patients stopped this drug.[Ref]

Hematologic

Decreased neutrophils (less than 750/mm3), hemoglobin (less than 7 g/dL), and platelet count (less than 50,000/mm3) have been reported in up to 5.1%, up to 2.4%, and up to 0.9% of patients, respectively.[Ref]